Depression and Cancer Archives

A new contribution to the European dialogue on safe, responsible and human-centred Artificial Intelligence in healthcare

Evangeli Bista, Co-founder and Head of Operations and Development of Kapa3 – Cancer Guidance Centre, has been invited to join the Expert Group of the European research and innovation project PATH – Patient AI Treatment Hub as an independent expert.

Her participation is undertaken in a personal and independent capacity, with her professional affiliation to Kapa3 – Cancer Guidance Centre, creating an opportunity to bring into the European dialogue experience gained through direct engagement with people affected by cancer, survivors, caregivers and healthcare professionals. The PATH Terms explicitly define Expert Group members as acting independently rather than as partners, employees, agents or subcontractors of the Consortium.

What is PATH – Patient AI Treatment Hub?

PATH – Patient AI Treatment Hub is a European research and innovation project focused on supporting the safe and effective integration of Artificial Intelligence into cancer care through the development of a secure, interoperable and privacy-preserving digital platform.

The project aims to explore how Artificial Intelligence tools can be safely integrated into cancer-care pathways, supporting healthcare professionals and contributing to more personalised approaches while safeguarding privacy and health data.

At the heart of this effort lies a critical question:

How can technological innovation create meaningful value for patients while preserving trust, human oversight, safety and equity?

Participation in the PATH Expert Group

As a member of the PATH Expert Group, Evangeli Bista will contribute independent expertise, opinions, input, comments and feedback in relation to selected project use cases and activities.

The experience developed through Kapa3’s work can contribute to discussions around issues such as:

patient-centred cancer care,
patient navigation across health and social-care systems,
equitable access to information and services,
health and digital literacy,
health and social rights,
responsible use and protection of health data,
transparency and human oversight in Artificial Intelligence systems,
meaningful involvement of patients and civil society in technology design,
and translating technological innovation into real value for people.

Why the Patient Voice Must Be Part of Innovation

Artificial Intelligence is creating new possibilities for healthcare and cancer care. At the same time, its growing use raises important questions concerning trust, transparency, safety, equitable access and human oversight.

For Kapa3, the development of a digital solution cannot begin solely with the question of what is technologically possible.

It must also ask:

What does the patient actually need?

Can people understand the information they receive?

Do they know where that information comes from?

Can they trust the system?

Is it clear when Artificial Intelligence is being used and when human professional judgement is required?

Could digital inequalities lead to new inequalities in healthcare?

And ultimately, does innovation genuinely improve the experience and pathway of a person facing cancer?

These are questions that we believe should remain at the centre of the European discussion on Artificial Intelligence in healthcare.

Kapa3’s experience in digital health

Evangeli Bista’s participation in the PATH Expert Group comes at a time when Kapa3 is systematically expanding its work in digital health, patient navigation and the responsible use of emerging technologies to support people affected by cancer.

This broader work also includes MYRTO – Digital Navigator for Health and Social Rights, an independent Kapa3 initiative developed to help transform complex and often fragmented information on rights, benefits and administrative procedures into more accessible, structured and evidence-based guidance for patients and caregivers.

MYRTO is not part of PATH, and the two initiatives are independent from one another.

However, the experience of developing patient-facing digital services has reinforced several principles that Kapa3 considers essential:

reliable information, transparent sources, understandable communication, data protection, human oversight and a clear pathway to professional support when technology alone is not enough.

This distinction is also important from an intellectual-property perspective, since the PATH Terms preserve intellectual property that exists independently of the Expert’s Services and is not incorporated into PATH Contributions.

From information to trust

Digital transformation in healthcare is not simply about more data, more algorithms or more applications.

It is about creating greater understanding, better access and stronger trust.

For a person facing cancer, information has value when it can be translated into a meaningful next step.

Technology has value when it reduces — rather than increases — complexity.

And Artificial Intelligence has value when it strengthens, rather than replaces, human care, professional judgement and the patient’s ability to participate meaningfully in decisions affecting their life and health.

A new opportunity to contribute to the European dialogue

For Kapa3, the invitation to Evangeli Bista to participate as an independent expert in the PATH Expert Group represents an important opportunity to bring into the European dialogue experience, needs and concerns emerging from the real-world context of cancer care and patient support.

The objective remains clear:

Artificial Intelligence in healthcare should advance with safety, transparency, responsibility, equitable access and meaningful involvement of the people it is designed to serve.

Because innovation creates real value when it is designed with people and for people.

PATH – Patient AI Treatment Hub | At a glance

Field: Artificial Intelligence and data in cancer care
Project: PATH – Patient AI Treatment Hub
Focus: Safe and effective integration of AI into cancer care through secure, interoperable and privacy-preserving approaches.
Expert Group: Independent external experts providing expertise, opinions, input, comments and feedback to the Project.
Independent Expert: Evangeli Bista
Professional role: Co-founder & Head of Operations and Development
Affiliation: Kapa3 – Cancer Guidance Centre

Depression is a common but often underrecognized condition among cancer patients, affecting up to 20–30% of individuals diagnosed with the disease. Beyond its impact on quality of life, mounting evidence suggests that depression can significantly influence cancer outcomes, including survival. A recent meta-analysis of 65 cohort studies spanning colorectal, breast, lung, prostate, and mixed cancers provides compelling evidence that depression diagnosed after a cancer diagnosis is associated with a substantially increased risk of mortality.

The analysis revealed that patients with depression faced an 83% higher risk of dying from colorectal cancer, a 59% higher risk in lung cancer, a 74% higher risk in prostate cancer, and a 23% higher risk in breast cancer compared to non-depressed patients. Across mixed cancer types, depression increased the risk of cancer mortality by 38%. These findings underscore that the psychological burden of cancer is not merely an emotional challenge but a critical factor affecting survival outcomes.

Mechanisms Linking Depression and Cancer Outcomes

Depression may influence cancer progression through multiple biological and behavioral pathways. Biologically, depression is associated with chronic systemic inflammation, dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, immune suppression, autonomic dysfunction, oxidative stress, and impaired DNA repair. Elevated pro-inflammatory cytokines, including interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α), can contribute to tumor growth and metastasis. In older patients, depression may exacerbate age-related immune dysfunction, creating an environment more permissive to cancer progression.

Behaviorally, depression affects health-related actions and treatment adherence. Depressed patients are more likely to delay seeking medical care, adhere poorly to chemotherapy, radiotherapy, and hormonal therapies, and engage in unhealthy habits such as smoking, poor nutrition, and physical inactivity. Social isolation and reduced support systems further increase vulnerability, compounding the negative impact on survival.

Clinical Implications and Interventions

The strong association between depression and cancer mortality highlights the urgent need to integrate mental health care into routine oncology practice. Psychological interventions, such as cognitive-behavioral therapy (CBT), supportive-expressive therapy, and mindfulness-based approaches, have shown promise in reducing distress and improving adherence to cancer treatment. Pharmacological management, including selective serotonin reuptake inhibitors (SSRIs), may also support mental health and potentially influence cancer outcomes, though more research is needed to understand their role fully. Early identification and treatment of depressive symptoms should be considered a priority for oncologists, mental health professionals, and healthcare policymakers alike.

Limitations and Future Directions

While this meta-analysis provides robust evidence, several limitations should be noted. The observational nature of the studies prevents establishing causality, and differences in study design, depression assessment methods, and patient populations contribute to heterogeneity. Future research should explore longitudinal and randomized studies to clarify causal pathways and identify the most effective interventions to reduce depression-related mortality. Investigating the interactions between depression, inflammation, and cancer biology may also reveal targets for novel supportive therapies.

Depression is not just a psychological burden for cancer patients—it is a significant predictor of mortality across multiple cancer types. These findings call for systematic depression screening and tailored interventions as integral components of oncology care.

Organizations like Kapa3 play a vital role in supporting the mental health of cancer patients, offering resources and guidance that can improve both quality of life and treatment outcomes. Integrating psychological support into cancer care ensures that mental well-being is recognized as an essential part of the healing process.
In line with this mission, Kapa3 participates in MELODIC, a new European initiative dedicated to supporting the mental health of young adults (18–30 years old) living with or beyond cancer.

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